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General NPI Number Information
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NPI Number | 1578883674
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Entity Type | Organization
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Legal Business Name | DOVE NEUROPSYCHIATRIC AND PAIN
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Dates
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Enumeration Date | 06/11/2010
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Last Update Date | 11/12/2015
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Provider Practice Location Address
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Address Line | 3939 RUFFIN ROAD
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City | SAN DIEGO
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State | CA
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Zip | 92123
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Country | US
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Telephone | 858-810-0382
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Fax | 858-633-0382
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Provider Business Mailing Address
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Address Line | PO BOX 1927
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City | LA JOLLA
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State | CA
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Zip | 92038-1927
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Country | US
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Telephone | 858-810-0382
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Fax | 858-633-0382
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Authorized Official
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Title or Position | M.D./PRESIDENT
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Name | KRISTI ANN DOVE
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Credential | M.D.
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Telephone | 858-810-0382
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | A55667
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | A55667
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License Number State | CA
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